| Mr Timothy Brannon, CRNA | |
|
615 W Nursery St, Butler, MO 64730-1840 | |
| (660) 200-7000 | |
| (660) 200-7015 |
| Full Name | Mr Timothy Brannon |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 25 Years |
| Location | 615 W Nursery St, Butler, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124071113 | NPI | - | NPPES |
| 919038307 | Medicaid | MO | |
| 912724317 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 148622 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Bates County Memorial Hospital | Butler, MO | Hospital |
| Southwest Medical Center | Liberal, KS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Bates County Memorial Hospital | 8123937356 | 33 |
| Southwest Medical Center | 7517941651 | 35 |
| Entity Name | Bates County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740311471 PECOS PAC ID: 8123937356 Enrollment ID: O20040121000624 |
| Entity Name | Cass Regional Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477535326 PECOS PAC ID: 7517853781 Enrollment ID: O20040225000028 |
| Entity Name | Capital Anesthesia Solutions Of Missouri, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770185472 PECOS PAC ID: 1456764885 Enrollment ID: O20210104001560 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Timothy Brannon, CRNA 615 W Nursery St, Butler, MO 64730-1840 Ph: (660) 200-7000 | Mr Timothy Brannon, CRNA 615 W Nursery St, Butler, MO 64730-1840 Ph: (660) 200-7000 |
Ms. Aida G Lawrence, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 615 W Nursery St, Butler, MO 64730 Phone: 660-200-7000 Fax: 660-200-7015 |